This REVISED Mentored Patient-Oriented Research Career Development Award proposal is designed to support the career development of Sheila Wang, PhD, and to provide important, new information on the impact of a CAM intervention, massage therapy, on multiple biologic parameters in HIV-infected adolescents, a high risk, underserved pediatric population. As many as one-half of all new HIV infections occur in persons under 25 years of age. Globally, there are 10 million children and adolescents living with HIV infection without access to highly active antiretroviral therapy (HAART), making it a compelling national and international health problem. While much attention has appropriately been focused on the urgent moral and ethical dilemma of providing medication to these people, we must simultaneously explore low cost, non- invasive strategies to enhance immune function for HIV-infected individuals who do not yet have access to HAART. Preliminary studies report immune enhancing effects of massage therapy for adolescents and children living with HIV infection. Relatively low cost CAM therapies, like massage, may have the potential to provide a safe, sustainable form of immunostimulation to children and adolescents while they are waiting for access to HAART and/or as an adjunct to pharmacotherapy. The proposed research utilizes a unique and novel multi-system evaluation of a massage therapy intervention that recognizes the complexity of biological systems and the impact of disease on multiple system interactions. This research project is a tool for career development and training including one on one mentoring from international experts Ram Yogev, MD (Pediatric/Adolescent HIV/AIDS and Immunology) and Iris Bell, MD, PhD, (Integrative Medicine); collaboration with Univ of IL professor Sue Carter, PhD (neuroendocrinology), "hands on" training experience in the Univ of IL lab of Stephen Porges, PhD (Heart Rate Variability); in the Northwestern Univ labs of Uri Wilensky, PhD and Luis Amaral, PhD (complex systems); and in the Children's Memorial Hospital Special Infectious Diseases Adolescent Clinic (Drs. Yogev and Garofalo). The research plan involves two components: 1) a preliminary randomized controlled trial of massage therapy vs relaxation training on immune, autonomic, hormonal and behavioral measures in HIV+ adolescents and 2) a comparison between multi-system response profiles of healthy and HIV+ adolescents. [unreadable] [unreadable] [unreadable] [unreadable]